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[ [ [ [ [ [ E C [ [ f [ I [ [ I C [ C <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date 11 /8 � Page of C <br /> :;.',.-;��...'.'-,`�: -"•' n/'Nnryltrnl Ccrlr/nr7ricr <br /> 1803 Wesl March Lane,Suite A-Stockton, California-95207-(209)956-0264-Fax(209)956-0700 <br /> Client Ngo Project Manager <br /> Tests Required <br /> Phone Number <br /> ova <br /> Samplers: (Signature) Invoice: <br /> Project Name f r r l ' _ AGE Igl <br /> Lt/(� o,.t.� ��•-C,('�-� Client ❑ <br /> Sample Location Sample Type t <br /> Date Time Water Solid No, of Notes <br /> Number Description <br /> Comp. Grab. Air Conts. �--- <br /> --' <br /> 71350 <br />,IP �Pl ��- �., ,� 71351 <br /> 1 <br /> t ,/ <br /> I 71352 <br /> f 1 <br /> `PI-1 o' qv� ,� 71353 tl <br /> 7135$ f <br /> t <br /> 71355 <br /> Relinquished y: (Signature) e s y: ( rgna <br /> r <br /> Date/Time�.� <br /> Relinquished by: (Signature) ved by: (Sig lure) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Dale/Time Received for Laboratory by: Date/Time <br /> Method of Shipment: Laboratory Name <br /> J ( av ei <br /> "If <br /> w oc <br /> Special Instructions: I hereby authorize the performance of the above Indicated work. <br /> - <br /> GOOD CONDITION APPROPRIATE ��7��,._t� A <br /> 0L eQrr�l <br />